Doctors advocate for immunizations as more parents claim exemptions in Massachusetts

Friday

Sep 15, 2017 at 12:01 AMSep 18, 2017 at 10:34 AM

THE ISSUE: A small but increasing number of parents have exempted their children from vaccination requirements.

THE IMPACT: Doctors say immunizations are important to prevent the spread of diseases.

Gerry Tuoti Wicked Local Newsbank Editor

While Massachusetts has one of the highest childhood vaccination rates in the country, there are pockets in the state where increasing numbers of parents are choosing to exempt their children from required immunizations.

“The more people you have that are unimmunized, the more risk there is to them and the population as a whole,” said Dr. Henry Dorkin, president of the Massachusetts Medical Society. “I have grave concerns over large numbers of people who, for non-medical reasons, are not having their children immunized.”

Massachusetts state law requires that children receive a series of immunizations, including the Measles-Mumps-Rubella vaccine, polio vaccine and the DtaP - or diphtheria, tetanus and acellular pertussis vaccine - before entering school. Children with certain documented medical conditions are exempted from receiving live vaccines.

Under state law, parents can also claim an exemption on religious grounds by signing a letter stating that vaccinating their child against disease violates a sincerely held religious belief. Beyond signing the letter, no proof of religious affiliation or belief is required.

Statewide, 1.3 percent of kindergarten students had an exemption in 2016, three-quarters of whom claimed religious exemptions, according to the state Department of Public Health.

Significantly higher concentrations of students with exemptions are clustered on the Cape and Islands and in Western Massachusetts. In Barnstable County, for example, 3.1 percent of kindergarteners had an exemption last year. On Martha’s Vineyard, the rate was 9.2 percent.

Dorkin declined to speculate on reasons behind the geographic patterns, but said increasing numbers of unimmunized people can compromise herd immunity. When immunization rates are high, that prevents the spread of diseases through the community, helping protect people who are not immunized. Unimmunized people may include organ transplant recipients, people with rare medical conditions, young infants and those claiming a religious exemption.

Herd immunity also protects the small number of people who don’t respond to vaccinations, Dorkin said.

“Immunizations are critically important,” he said. “They are one of the best, most effective values in terms of health care imaginable.”

The number of people claiming religious exemptions has risen in recent years. Dorkin said he attributes the trend to some parents’ misguided fears and the spread of misinformation, including a 1998 study that claimed a link between the measles vaccine and autism – a study that has since been debunked by the professional medical community.

In 2000, 354 kindergarten students had religious exemptions statewide. In 2016, there were 702 religious exemptions, and that came as the total number of kindergarten students in the state dropped from 80,971 to 70,109 over the 16-year span.

Jamie Murphy, the Watertown-based author of the 1993 book “What Every Parent Should Know About Childhood Immunization,” researched old medical journal articles and studies. He believes all vaccinations are dangerous and accuses the medical community and political establishment of intentionally misleading the public.

“The real problem is that we have a medical procedure written into the law,” Murphy said. “There’s no other law that forces a person to get a certain medical procedure. It’s free choice for all.”

He points to reports in the federal Vaccine Adverse Event Reporting System database as evidence of injuries and deaths linked to immunizations. The Centers for Disease Control and Prevention, however, maintains that such claims are misleading. The VAERS database tracks reports of incidents occurring around the time of vaccination, but does not prove that such incidents are actually the result of vaccination, according to the CDC. Serious injuries and death are statistically extremely rare, the CDC says, and the overwhelming majority of side effects are minor, such as a sore arm or mild fever.

The risk of a serious side effect from a vaccination is much smaller than the risk of a serious complication from contracting a preventable illness, according to the CDC. The risk of dying after contracting measles, for example, is two in 1,000. The risk of getting encephalitis or having a severe allergic reaction from the MMR vaccine is one in 1 million, according to the CDC.

“People have misconceptions about the risks of immunizations,” Dorkin said. “While nothing in the world is without risk, the risk is extremely small there. The risk of side effects from immunization is exceedingly small compared to the risk of extreme complications from these diseases. No parent wants to have their child neurologically devastated or impaired for life because they didn’t immunize their child.”